US president pays surprise visit to Afghanistan

Washington, Apr 28: After nearly three weeks in an intensive care unit in Los Angeles, doctors treating 41-year-old Broadway actor Nick Cordero for COVID-19 were forced to amputate his right leg.

The flow of blood had been impeded by a blood clot: yet another dangerous complication of the disease that has been bubbling up in frontline reports from China, Europe and the United States.

To be sure, so-called "thrombotic events" occur for a variety of reasons among intensive care patients, but the rates among COVID-19 patients are far higher than would be otherwise expected.

"I have had 40-year-olds in my ICU who have clots in their fingers that look like they'll lose the finger, but there's no other reason to lose the finger than the virus," Shari Brosnahan, a critical care doctor at NYU Langone said.

One of these patients is suffering from a lack of blood flow to both feet and both hands, and she predicts an amputation may be necessary, or the blood vessels may get so damaged that an extremity could drop off by itself.

Blood clots aren't just dangerous for our limbs, but can make their way to the lungs, heart or brain, where they may cause lethal pulmonary embolisms, heart attacks, and strokes.

A recent paper from the Netherlands in the journal Thrombosis Research found that 31 percent of 184 patients suffered thrombotic complications, a figure that the researchers called "remarkably high" -- even if extreme consequences like amputation are rare.

Behnood Bikdeli, a doctor at New York-Presbyterian Hospital, assembled an international consortium of experts to study the issue. Their findings were published in the Journal of The American College of Cardiology.

The experts found the risks were so great that COVID-19 patients "may need to receive blood thinners, preventively, prophylactically," even before imaging tests are ordered, said Bikdeli.

What exactly is causing it? The reasons aren't fully understood, but he offered several possible explanations.

People with severe forms of COVID-19 often have underlying medical conditions like heart or lung disease -- which are themselves linked to higher rates of clotting.

Next, being in intensive care makes a person likelier to develop a clot because they are staying still for so long. That's why for example people are encouraged to stretch and move around on long haul flights.

It's also now clear the COVID-19 illness is associated with an abnormal immune reaction called "cytokine storm" -- and some research has indicated this too is linked to higher rates of clotting.

There could also be something about the virus itself that is causing coagulation, which has some precedent in other viral illnesses.

A paper in the journal The Lancet last week showed that the virus can infect the inner cell layer of organs and of blood vessels, called the endothelium. This, in theory, could interfere with the clotting process.

According to Brosnahan, while thinners like Heparin are effective in some patients, they don't work for all patients because the clots are at times too small.

"There are too many microclots," she said. "We're not sure exactly where they are."

Autopsies have in fact shown some people's lungs filled with hundreds of microclots.

The arrival of a new mystery however helps solve a slightly older one.

Cecilia Mirant-Borde, an intensive care doctor at a military veterans hospital in Manhattan, told AFP that lungs filled with microclots helped explain why ventilators work poorly for patients with low blood oxygen.

Earlier in the pandemic doctors were treating these patients according to protocols developed for acute respiratory distress syndrome, sometimes known as "wet lung."

But in some cases, "it's not because the lungs are occupied with water" -- rather, it's that the microclotting is blocking circulation and blood is leaving the lungs with less oxygen than it should.

It has just been a little under five months since the virus emerged in Wuhan, China, and researchers are learning more about its impact every day.

"While we react surprised, we shouldn't be as surprised as we were. Viruses tend to do weird things," said Brosnahan.

While the dizzying array of complications may seem daunting, "it's possible there'll be one or a couple of unifying mechanisms that describe how this damage happens," she said.

"It's possible it's all the same thing, and that there'll be the same solution."

Islamabad, Jun 25: The coronavirus cases in Pakistan crossed the 192,000-mark after 4,044 new Covid-19 infections were detected in the last 24 hours, the health ministry said on Thursday.

According to the Ministry of National Health Services, 148 more people died due to the deadly virus in the country, taking the death toll to 3,903.

With the detection of 4,044 new cases in the last 24 hours, the coronavirus tally in the country now stands at 192,970, it said.

Sindh reported a maximum number of 74,070 infections, followed by 71,191 in Punjab, 23,887 in Khyber-Pakhtunkhwa, 11,710 in Islamabad, 9,817 in Balochistan, 1,365 in Gilgit-Baltistan and 930 in Pakistan-occupied Kashmir.

A total of 81,307 patients have recovered so far from the disease.

Health authorities have so far conducted 1,171,976 coronavirus tests, including 21,835 in the last 24 hours.

Beijing, Jul 6: A city in northern China on Sunday sounded an alert after a suspected case of bubonic plague was reported, according to official media here.

Bayannur, Inner Mongolia Autonomous Region, announced a level III warning of plague prevention and control, state-run People’s Daily Online reported.

The suspected bubonic plague case was reported on Saturday by a hospital in Bayannur. The local health authority announced that the warning period will continue until the end of 2020.

"At present, there is a risk of a human plague epidemic spreading in this city. The public should improve its self-protection awareness and ability, and report abnormal health conditions promptly,” the local health authority said.

On July 1, state-run Xinhua news agency said that two suspected cases of bubonic plague reported in Khovd province in western Mongolia have been confirmed by lab test results.

The confirmed cases are a 27-year-old resident and his 17-year-old brother, who are being treated at two separate hospitals in their province, it quoted a health official as saying.

The brothers ate marmot meat, the health official said, warning people not to eat marmot meat.

A total of 146 people who had contact with them have been isolated and treated at local hospitals, according to Narangerel.

Bubonic plague is a bacterial disease that is spread by fleas living on wild rodents such as marmots. It can kill an adult in less than 24 hours if not treated in time, according to the World Health Organization (WHO).

A couple died of bubonic plague in the western Mongolian province of Bayan-Ulgii last year after eating raw marmot meat.

The news of bubonic plague came after Chinese researchers issued an early warning over another potential pandemic caused by an influenza virus in pigs.

Scientists from China Agricultural University, the Chinese Centre for Disease Control and Prevention and other institutes detected a pig influenza virus bearing genotype 4 (G4), which is contagious among pigs and has the possibility of jumping to humans, as the G4 virus is able to bind with human cells, state-run Global Times reported last week.

The researchers are concerned that it could mutate further so that it can spread easily from person to person, and trigger a global outbreak, BBC reported.

"Controlling the prevailing G4 EA H1N1 viruses in pigs and close monitoring in human populations, especially workers in the swine industry, should be urgently implemented," Chinese researchers warned in the paper.

The new diseases were reported even as China grappled with the second attack of Covid-19 in Beijing after controlling it in Wuhan where it was first reported in December last year.

On Saturday, Beijing reported a single-digit Covid-19, local authorities said Sunday.

The number of newly confirmed Covid-19 cases reached a peak in Beijing on June 13 and 14 and then started declining in general, Xinhua quoted local officials as saying.

From June 11 to July 4, the city reported 334 confirmed locally transmitted cases, 47 per cent of whom are workers of the Xinfadi wholesale food market, the official said.